Background
Australia’s National Bowel Cancer Screening Program
Screening participation in Australia
Methods
Study population
Questionnaire
Risk category* | |
---|---|
At or slightly above average risk | • No personal history of bowel cancer. |
• Either no close relatives with bowel cancer or one first-degree or second-degree relative with bowel cancer diagnosed at age 55 years or older. | |
Moderately increased risk | • One first-degree relative diagnosed before the age of 55 years (without potentially high-risk features listed below), or |
• Two first-degree relatives or one first- and one second-degree relative(s) on the same side of the family (without potentially high-risk features listed below). | |
Potentially high risk | • Three or more first-degree or a combination of first-degree and second-degree relatives on the same side of the family diagnosed with bowel cancer (suspected HNPCC**), or |
• Two or more first-degree or second-degree relatives on the same side of the family diagnosed with bowel cancer, including the following risk feature: bowel cancer before the age of 50 years or at least one-relative with cancer of the endometrium, ovary, stomach, small bowel, renal pelvis, ureter, biliary tract or brain. |
Predictors of CRC screening behaviour
Statistical analysis
Results
Characteristics of the sample
Inclusion and exclusion for CRC screening
Characteristic | n | %** | |
---|---|---|---|
Socio-demographic | |||
Gender* | Male | 363 | 48 |
Female | 397 | 52 | |
Age (years)* | 56-64 | 317 | 42 |
65-74 | 268 | 36 | |
75-88 | 168 | 22 | |
Marital status* | In Relationship | 575 | 79 |
Not in Relationship | 155 | 21 | |
Education* | Secondary schooling (not-completed) | 164 | 22 |
Secondary schooling (completed) | 162 | 22 | |
Trade qualification or TAFE: | 189 | 26 | |
University or other tertiary study | 181 | 25 | |
Other or not applicable | 33 | 5 | |
Household income before tax ($)* | <= 39, 999 | 389 | 57 |
40, 000 – 69, 999 | 152 | 22 | |
>= 70,000 | 146 | 21 | |
Country of birth* | Australian | 619 | 89 |
Other | 76 | 11 | |
Retired* | Yes | 453 | 62 |
Private health insurance* | No-coverage | 191 | 26 |
Coverage | 531 | 74 | |
Alcohol* | Drink days per month | Mean =11 | SD =11 |
Smoking* | Ever | 346 | 48 |
Never | 382 | 52 | |
Clinical | |||
Number of GP visits over the past 12 months* | None to twice | 187 | 25 |
Three to six | 411 | 56 | |
> six | 137 | 19 | |
Previous cancer (excluding CRC)* | Yes | 163 | 22 |
Risk Category | At or slightly above average risk | 707 | 93 |
Moderately increased risk | 34 | 4 | |
Potentially high risk | 19 | 3 | |
Discussion of family history of CRC with doctor | Never discussed | 523 | 70 |
Discussed, informed of ‘increased risk’ | 133 | 18 | |
Discussed, not informed of ‘increased risk’ | 90 | 12 | |
Ever received screening advice from doctor | Yes | 195 | 28 |
BMI* | < 18.5 | 7 | 1 |
18.5 – 25 | 130 | 19 | |
> 25 | 555 | 80 | |
Chronic health condition* | Yes | 554 | 76 |
Psychosocial | |||
SF-36 (physical health score)* | Mean = 52 | SD = 9 | |
K-10 (mental health score)* | Low or no risk (10–15) | 555 | 75 |
Medium to high risk (16 +) | 184 | 25 |
Ever received CRC testing
Characteristic | n** (%) | OR (95% CI) |
p value |
---|---|---|---|
Age (years) | |||
56-64 | 172 (57) | 1 | |
65-74 | 171 (71) | 2.00 (1.36, 2.97) | <.001 |
75-88 | 86 (59) | 1.27 (.82, 1.96) | .286 |
Discussion of family history of CRC with doctor | |||
Never discussed | 248 (52) | 1 | |
Discussed/ informed of possible ‘increased risk’ | 114 (90) | 4.13 (2.12, 8.05) | <.001 |
Discussed/ not informed of possible increased ‘risk’ | 67 (83) | 3.78 (2.02, 7.05) | <.001 |
Ever received screening advice from doctor | |||
No | 264 (53) | 1 | |
Yes | 165 (88) | 3.59 (2.11, 6.08) | <.001 |
CRC screening in accordance with national screening guidelines
Characteristic | n** (%) | OR (95% CI) |
p value |
---|---|---|---|
Age (years) | |||
56-64 | 46 (17) | 1 | |
65-74 | 59 (29) | 2.71 (1.64, 4.49) | <.001 |
75-88 | 21 (18) | 1.57 (.83, 2.96) | .166 |
Annual household income before tax ($) | |||
<= 39, 999 | 60 (18) | 1 | |
40, 000 – 69, 999 | 27 (21) | 1.28 (.74, 2.21) | .380 |
>= 70,000 | 39 (30) | 2.59 (1.50, 4.49) | <.001 |
Ever received screening advice from doctor | |||
No | 72 (16) | 1 | |
Yes | 54 (38) | 3.00 (1.95, 4.64) | <.001 |
Characteristic | n** (%) | OR (95% CI) |
p value |
---|---|---|---|
Private health insurance | |||
No-coverage | 3 (18) | 1 | |
Coverage | 19 (58) | 8.46 (1.58, 45.39) | .013 |
Discussion of family history of CRC with doctor | |||
Never discussed | 3 (14) | 1 | |
Discussed/ informed of ‘increased risk’ | 17 (68) | 16.34 (3.19, 83.55) | .001 |
Discussed/ not informed of increased ‘risk’ | 2 (67) | 17.50 (.83, 368.04) | .066 |
Recent colonoscopy screening irrespective of level of risk
Characteristic | n** (%) | OR (95% CI) |
p value |
---|---|---|---|
Smoking | |||
Never | 47 (14) | 1 | |
Ever | 63 (20) | 1.89 (1.15, 3.10) | .012 |
Discussion of family history of CRC with doctor | |||
Never discussed | 30 (6) | 1 | |
Discussed/ informed of ‘increased risk’ | 65 (53) | 7.20 (3.95, 13.09) | <.001 |
Discussed/ not informed of increased ‘risk’ | 15 (20) | 2.30 (1.11, 4.76) | .002 |
Ever received screening advice from doctor | |||
No | 31 (6) | 1 | |
Yes | 79 (44) | 4.60 (2.65, 8.00) | <.001 |
Private health insurance | |||
No-coverage | 17 (10) | 1 | |
Coverage | 93 (19) | 1.84 (.97, 3.50) | .062 |